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61.
62.
Amiodarone-induced thyrotoxicosis (AIT) is a complex therapeutic challenge. Two major forms have been described: type I and type II. Methimazole (MMI) and potassium perchlorate (KCLO(4)) is the treatment of choice for the former, whereas corticosteroids are used for the latter. However, mixed forms appear frequently and it is not easy to prescribe corticosteroids because of side effects. The present study investigated the validity of a stepwise therapeutic approach to AIT. Twenty patients with AIT were given 30-50 mg/d of MMI and 1000 mg/d of KCLO(4) initially for a month. Euthyroidism or a significant decrease in serum thyroid hormone levels could be achieved in 12 of the patients (7 with type I, 5 type II). Prednisolone, 40-48 mg/d was added for the 8 nonresponding patients (7 type I, 1 type II) and euthyroidism was achieved in all. The prednisolone dose was decreased when free thyroxine (T(4)) levels normalized, and MMI was titrated, maintaining euthyroidism until urinary iodine excretion normalized. Mixed forms of AIT may prevail in iodine-deficient areas. Initial classification of the patients may cause unnecessary corticosteroid use in a substantial number of patients with AIT. A stepwise approach is feasible; however, when the patient is gravely ill, MMI, KCLO(4), and prednisolone could be prescribed simultaneously. 相似文献
63.
Bozkurt B Mesci L Irkec M Ozdag BB Sanal O Arslan U Ersoy F Tezcan I 《Clinical & experimental ophthalmology》2012,40(4):e156-e162
Background: Tumour necrosis factor‐alpha (TNF‐α) is an important proinflammatory cytokine driving axonal degeneration and retinal ganglion cell apoptosis in glaucoma. The aim of the study was to evaluate the association of TNF‐α ‐308 G/A and ‐238 G/A polymorphisms with primary open‐angle glaucoma (POAG). Design: A prospective, case–control study, university hospital setting. Participants: Eighty‐six POAG patients and 193 healthy unrelated controls. Methods: TNF‐α polymorphisms were screened by using direct gene sequencing. Main Outcome Measures: Frequency of TNF‐α ‐308 G/A and TNF‐α ‐238 G/A promoter polymorphisms in glaucoma and healthy subjects. Results: The frequencies of TNF‐α ‐308 GA genotype and ‘A’ allele were higher in patients with POAG (22.1% and 12.2%, respectively) in comparison with the control group (10.9% and 6%, respectively) (P = 0.046 and 0.02, respectively), with odds ratios of 2.45 (P = 0.01, 95% CI = 1.23–4.87) and 2.19 (P = 0.013, 95% CI = 1.18–4.08), respectively. Genotype distribution of the TNF‐α ‐238 variants did not yield a statistically significant difference between the two groups (P = 0.87). Conclusion: TNF‐α ‐308 G/A polymorphism seems to be associated with POAG in Turkish population. However, population‐based studies with large number of subjects and long‐term follow‐up are needed to verify the association of TNF‐α ‐308 G/A polymorphism with glaucoma susceptibility. 相似文献
64.
Transgenic mouse models for lung cancer 总被引:1,自引:0,他引:1
Zhao B Magdaleno S Chua S Wang YL Burcin M Elberg D Finegold M Tsai S DeMayo FJ 《Experimental lung research》2000,26(8):567-579
65.
In this study, to determine whether symptoms and ECG abnormalities relate to left ventricular (LV) mass, volume, and mass/volume (M/V) ratio in children with aortic stenosis (AS) and/or insufficiency (AI), the authors examined 23 patients with echocardiography. LV volumes and mass were calculated with echocardiography. Also, the peak and mean gradients across the aortic valve and left ventricular meridional wall stress (ESWS) were determined by use of echo Doppler techniques. Fourteen patients (mean age 5.84+/-3.49 years) had AS alone. Of these, 14 had symptoms and seven had abnormal-appearing ECGs. Nine patients (mean age 6.91+/-4.35 years) had AS/AI. Of these nine, four had symptoms and two had ECG abnormalities. The authors observed that the incidences of symptoms and ECG abnormalities were higher in the patients with AS than in those with AS/AI. There was no significant correlation between symptoms and ECG abnormalities with peak gradient, mean gradient, valve area, LV mass, volume, and mass/volume ratio in patients with AS/AI. However, significant correlation was found between symptoms and ECG abnormalities and ESWS in AS/AI patients. In conclusion, ECG abnormalities and symptoms do not always indicate the severity of AS and AS/AI. 相似文献
66.
Although some studies have suggested that osteoporosis and osteoarthritis are inversely related in epidemiologic terms, a
spectrum of relations between the two diseases has been described in this study. In 95 postmenopausal women (mean age 64.4 ± 8.49
years, range 49–83 years), we investigated the relation between bone mineral density (BMD) in the femoral neck and lumbar
vertebrae (L2–L4) and osteoarthritis in the knee. BMD was measured with dual X-ray absorptiometry. Osteoarthritis was evaluated
with anterior–posterior weight-bearing radiographs with the knee in extension, and these were graded for severity on a 5-point
scale according to the Kellgren–Lawrence criteria. We found no clear statistical relation between BMD in the femoral neck
or lumbar vertebrae and osteoarthritis in the knee. Given that some studies have found BMD to be significantly higher in patients
with osteoarthritis, the lack of such relation in our patients may be due to environmental and/or genetic factors. 相似文献
67.
Emire Seyahi Ayca Ucgul Deniz Cebi Olgun Serdal Ugurlu Canan Akman Onur Tutar Sebahattin Yurdakul Hasan Yazici 《Seminars in arthritis and rheumatism》2013
Objectives
Atherosclerosis is well recognized in Takayasu arteritis (TAK) and the associated plaques tend to be more common in areas of arteritis. We now report arterial wall calcification in a large group of TAK patients and controls. We hypothesized that the degree of coronary artery calcification would point to a systemic effect of inflammation while that in the thoracic aorta more of local inflammation.Methods
A total of 47 patients with TAK, 43 patients with SLE and 70 healthy controls (HC) were studied. The presence of coronary artery and thoracic aorta calcifications (ToAC) was investigated by multi-detector computed tomography (MDCT). Atherosclerotic plaques in the carotid arteries were screened using B mode ultrasound.Results
The frequency of coronary artery calcification was significantly increased among patients with SLE as compared to the healthy controls while the increase in TAK did not reach statistical significance. There were more TAK patients with ToAC among the TAK as compared to the SLE patients [21/47 (45%) vs 10/43 (23%), P = 0.033]. In addition, a circumferential type of calcification, vs a punctuate or linear type, was the more common type in 67% of patients with TAK whereas only the linear or punctuate type was seen in SLE patients and HC. SLE and TAK patients were found to have increased risk for carotid artery plaques. Among TAK patients, coronary artery calcification, ToAC and carotid artery plaques tend to be at sites of primary vasculitic involvement.Conclusions
There is increased atherosclerosis in TAK and SLE. Vessel wall inflammation seems to be also important in the atherosclerosis associated with TAK. 相似文献68.
Leopoldo E Landa Burcin F Tartan Aguz Acartuk Chris A Skouteris Christopher Gordon George C Sotereanos 《Journal of oral and maxillofacial surgery》2003,61(3):343-346
PURPOSE: The aim of this study was to evaluate the long-term outcome of the transcervical approach to treat various mandibular problems. MATERIALS AND METHODS: Sixty-two patients (37 males and 25 females; age range, 15 to 80 years; mean age, 45.1 years) were treated via the transcervical approach. Twenty-eight patients (45.1%) had multiple mandibular fractures, 23 (31.7%) had tumor resections and selective neck dissections with microsurgical reconstruction, 7 (11.3%) had severe micrognathia and temporomandibular joint ankylosis, and 4 (6.4%) had mandibular atrophy requiring grafting. The patients were followed up to 15 years. The rates of complications due to surgery were evaluated. RESULTS: The most common complication was dysesthesia at the C2-4 distribution in 54 patients (87.1%), which was usually transient. Nine patients (12.9%) had permanent damage to the inferior alveolar nerve (V3) unilaterally due to segmental mandibulectomy. Other less common complications were transient dysesthesia at the V3 distribution and transient weakness of the lip commissure unilaterally. Hypertrophic scars, seroma formation, soft tissue infection, and orocervical fistula formation were rare. Most of the patients (96.8%) were satisfied with the amount of scarring. CONCLUSION: The transcervical approach provides broad exposure of the mandible and neck structures with excellent access to the operative field and a minimal rate of complications. 相似文献
69.
Surgical treatment of gallbladder cancer 总被引:14,自引:0,他引:14
C. Burcin Taner David M. Nagorney John H. Donohue 《Journal of gastrointestinal surgery》2004,8(1):83-89
Gallbladder cancer is usually a fatal illness because early stages of this carcinoma cause no specific signs or symptoms.
Although the best chance of cure for gallbladder cancer remains incidental discovery, radical resection of the gallbladder,
with the adjacent liver, adherent structures, plus a regional lymphadenectomy, has been suggested to improve survival. We
retrospectively analyzed all patients with gallbladder cancer who were treated surgically at Mayo Clinic (Rochester) between
1984 and 2000. There were 131 patients for whom complete survival information was available. Patients who underwent a radical
cholecystectomy had a significantly longer median survival (24 months) than patients who had a simple cholecystectomy (6 months)
or noncurative treatment (4 months) (P < 0.0001). The radical cholecystectomy group had significantly longer survival than the simple cholecystectomy group for
all American Joint Committee on Cancer (AJCC) stages except stage I. Of the different variables tested in a univariate analysis
(sex, surgical treatment modality, AJCC stage, tumor grade, jaundice, hyperbilirubinemia, and adjuvant therapy), all variables
except sex, tumor grade, and adjuvant therapy were statistically significant predictors for the survival of patients with
gallbladder cancer. AJCC stage and surgical treatment modality were the only significant predictors in a multivariate analysis.
Our results support radical surgical resection for the treatment of gallbladder cancer to improve patient survival.
Presented at the Forty-Fourth Annual Meeting of The Society for Surgery of the Alimentary Tract, Orlando, Florida, May 18–21,
2003 (oral presentation). 相似文献
70.